Case report: primary CD30 (Ki-1)-positive anaplastic large cell lymphoma of the duodenum

Two secondary localisation of non-Hodgkin's lymphomas in the upper gastrointestinal tract

Extranodal non-Hodgkin's lymphomas of the gastrointestinal tract represent 30%-40% of all extranodal lymphomas. Gastric lymphomas are increasingly described in the literature due to the development of diagnostic techniques and the increased incidence, together with the reduced incidence of gastric solid neoplasms. Significant diagnostic difficulties are determined by the non-specificity of the symptoms, which are mostly chronic, characterised by a slow progression. Localisation in the small intestine often appears as surgical urgency, due to the development of an intestinal obstruction or enterorrhagia. We present two cases of extranodal diffuse large B-cell lymphoma localisation, presented as a secondary lesion localised in the first one in the stomach, and in the second one in the first duodenal portion.

Primary pancreatic anaplastic large cell lymphoma, ALK negative: A case report

We present the fourth case of a primary pancreatic anaplastic large cell lymphoma (ALCL), ALK-. An 80-year-old man was admitted to our clinic for further investigation of a fever of unknown origin. He noted anorexia, weight loss and fatigue. His laboratory tests showed anemia and a great elevation of ESR, LDH, and β₂ microglobulin. In CT and MRI scan, a soft tissue mass in the pancreas was observed. A repeated endoscopy after his admission revealed an ulcerated mass-like deformity of the duodenal bulb. Explorative laparotomy confirmed a diffuse spread of an unresectable malignant pancreatic mass extending to the adjacent organs. Duodenal and surgical biopsies identified an ALCL of T-cell lineage, ALK-. The patient died in the Intensive Care Unit due to hemodynamic instability. Our case is the first one indicating that primary pancreatic lymphoma should be suspected in a patient with pancreatic mass and elevated serum LDH and β₂ microglobulin.